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Involvement of eicosanoids in the pathogenesis of pancreatic cancer: the roles of cyclooxygenase-2 and 5-lipoxygenase.

Abstract
The interplay between inflammation and cancer progression is a growing area of research. A combination of clinical, epidemiological, and basic science investigations indicate that there is a relationship between inflammatory changes in the pancreas and neoplastic progression. Diets high in ω-6 polyunsaturated fatty acids provide increased substrate for arachidonic acid metabolism by cyclooxygenase-2 (COX-2) and 5-lipoxygenase (5-LOX) to form eicosanoids. These eicosanoids directly contribute to pancreatic cancer cell proliferation. Both COX-2 and 5-LOX are upregulated in multiple cancer types, including pancreatic cancer. In vitro studies using pancreatic cancer cell lines have demonstrated upregulation of COX-2 and 5-LOX at both the mRNA and protein levels. When COX-2 and 5-LOX are blocked via a variety of mechanisms, cancer cell proliferation is abrogated both in vitro and in vivo. The mechanism of COX-2 has been shown to include effects on apoptosis as well as angiogenesis. 5-LOX has been implicated in apoptosis. The use of COX-2 and 5-LOX inhibitors in clinical studies in patients with pancreatic cancer has been limited. Patient enrollment has been restricted to those with advanced disease which makes evaluation of these drugs as chemopreventive agents difficult. COX-2 and 5-LOX expression have been shown to be present during the early neoplastic changes of pancreatic cancer, well before progression to invasive disease. This indicates that the ideal role for these interventions is early in the disease process as preventive agents, perhaps in patients with chronic pancreatitis or hereditary pancreatitis.
AuthorsLawrence M Knab, Paul J Grippo, David J Bentrem
JournalWorld journal of gastroenterology (World J Gastroenterol) Vol. 20 Issue 31 Pg. 10729-39 (Aug 21 2014) ISSN: 2219-2840 [Electronic] United States
PMID25152576 (Publication Type: Journal Article, Review)
Chemical References
  • Antineoplastic Agents
  • Cyclooxygenase 2 Inhibitors
  • Eicosanoids
  • Leukotriene Antagonists
  • Lipoxygenase Inhibitors
  • Receptors, Leukotriene B4
  • Arachidonate 5-Lipoxygenase
  • Cyclooxygenase 2
Topics
  • Animals
  • Antineoplastic Agents (therapeutic use)
  • Arachidonate 5-Lipoxygenase (metabolism)
  • Cyclooxygenase 2 (metabolism)
  • Cyclooxygenase 2 Inhibitors (therapeutic use)
  • Eicosanoids (metabolism)
  • Humans
  • Inflammation (drug therapy, enzymology, epidemiology, pathology)
  • Leukotriene Antagonists (therapeutic use)
  • Lipoxygenase Inhibitors (therapeutic use)
  • Pancreatic Neoplasms (drug therapy, enzymology, epidemiology, pathology)
  • Receptors, Leukotriene B4 (antagonists & inhibitors, metabolism)
  • Risk Factors
  • Signal Transduction

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